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New challenges emerge when your child with
diabetes begins school. Starting a good communication
system with key people at the school can help make this transition a smooth one. It's helpful to schedule a conference with school personnel—principal,
teachers, coaches, bus driver, school nurse, and lunchroom workers—after your
child is first diagnosed. Do this again at the beginning of each school year.
Your child needs to always have available the supplies for doing a
blood sugar test. If
possible, the school nurse will have these supplies available also.
Snacks, school lunches, and party food
are issues that need to be addressed before your child starts school.
If your child takes insulin, his or her teacher needs to understand why
snacks are so important. Explain how snacks prevent low blood sugar. Teachers
should know that snacks should never be withheld or delayed. Provide details on
when your child needs snacks—for example, during the day and either before,
during, or after exercise.
Your child can have regular school
lunches. If there are many items to choose from, your child needs to understand
the meal plan thoroughly to make the best choices. Ask to be informed in
advance if meals will be delayed because of special school activities, such as
parties or trips, so that your child's insulin or snack schedule can be adjusted
accordingly to prevent a low blood sugar episode.
A treatment plan should list:
The plan should specify how your child's needs are taken
care of and which member of the school staff is responsible for implementing
the plan. Your child may need an emergency glucagon shot if he or she is having
an episode of low blood sugar. Because of this, the school must select a person
in advance to give the glucagon. Your child can then have treatment without
A diabetes educator can help you make a treatment plan for
your child. Update the plan each school year.
For children who take
insulin, low blood sugar can result from additional exercise or not enough
food, as well as from too much insulin. Have your child carry a quick-acting
source of carbohydrate, such as glucose tablets, glucose gel, or juice, to be used in case of a low blood sugar episode.
your child can identify and treat symptoms of low blood sugar, or ask a teacher
for help. Also, have your child carry snack foods, such as pretzels, snack
crackers, or a sandwich, to cover unplanned activity or delayed meals. It's a
good idea to ask your child's teacher to keep one or more of these items in his
or her desk.
January 23, 2012
John Pope, MD - Pediatrics & Stephen LaFranchi, MD - Pediatrics, Pediatric Endocrinology
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